PubMed · 3718306
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R L Anderson. 1986. Mohs' micrographic technique.. https://doi.org/10.1001/archopht.1986.01050180052029
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We report a 59-year-old man who had a slowly enlarging mass of the central upper eyelid that proved histopathologically to be a benign mixed tumor (pleomorphic adenoma) arising from an accessory lacrimal gland of Wolfring. The tumor was totally separate from the main lacrimal gland, and its deep location in the lid excluded origin from dermal sweat glands. Benign mixed tumors of the accessory lacrimal glands are exceedingly rare tumors of the ocular adnexa.
Partial or total lower lid reconstruction implies the repair of three layers: the skin, the tarsus, and the conjunctiva. The method of reconstruction must, therefore, aim at three objectives: ensuring the stability of the lid by repairing the tarsoconjunctival layer, achieving an aesthetic result with the repair of the skin, and taking into consideration the primary role of the upper lid in the ocular protective system. We recommend a musculocutaneous flap, taken from the upper lid, with a single lateral or medial pedicle combined with a chondromucosal alar graft. During the last 10 years, 41 patients were operated on with malignant skin tumors requiring marginal, partial, and total lower lid reconstruction. The results were quite satisfactory from a functional and aesthetic point of view. We noticed two cases of partial flap necrosis and two cases of ectropion needing revision. We believe that the procedure described can be a tool in the armamentarium of the plastic surgeon involved in the field of the orbitopalpebral area.
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